Attoh Seth, Segborwotso Roxana P, Akoriyea Samuel K, Teddy Gina, Edusei Lawrence, Hobenu Frederick, Agyemang-Bediako Kwasi, Toppar Alfred, Fatchu Raymond D, Akakpo Patrick K
Pathology Division, 37 Military Hospital, Accra, Ghana.
Ga-East Municipal Hospital, Accra, Ghana.
Ghana Med J. 2020 Dec;54(4 Suppl):52-61. doi: 10.4314/gmj.v54i4s.9.
Since the declaration of COVID-19 by the World Health Organisation (WHO) as a global pandemic on 11th March 2020, the number of deaths continue to increase worldwide. Reports on its pathologic manifestations have been published with very few from the Sub-Saharan African region. This article reports autopsies on COVID-19 patients from the Ga-East and the 37 Military Hospitals to provide pathological evidence for better understanding of COVID-19 in Ghana.
Under conditions required for carrying out autopsies on bodies infected with category three infectious agents, with few modifications, complete autopsies were performed on twenty patients with ante-mortem and/or postmortem RT -PCR confirmed positive COVID-19 results, between April and June, 2020.
There were equal proportion of males and females. Thirteen (65%) of the patients were 55years or older with the same percentage (65%) having Type II diabetes and/or hypertension. The most significant pathological feature found at autopsy was diffuse alveolar damage. Seventy per cent (14/20) had associated thromboemboli in the lungs, kidneys and the heart. Forty per cent (6/15) of the patients that had negative results for COVID-19 by the nasopharyngeal swab test before death had positive results during postmortem using bronchopulmonary specimen. At autopsy all patients were identified to have pre-existing medical conditions.
Diffuse alveolar damage was a key pathological feature of deaths caused by COVID-19 in all cases studied with hypertension and diabetes mellitus being major risk factors. Individuals without co-morbidities were less likely to die or suffer severe disease from SARS-CoV-2.
None declared.
自2020年3月11日世界卫生组织（WHO）宣布新冠病毒病（COVID-19）为全球大流行以来，全球死亡人数持续增加。关于其病理表现的报告已发表，但撒哈拉以南非洲地区的报告很少。本文报告了来自加东医院和37军医院的COVID-19患者的尸检情况，以提供病理证据，以便更好地了解加纳的COVID-19情况。
在对感染三类传染病原体的尸体进行尸检所需的条件下，略作修改，于2020年4月至6月期间，对20例生前和/或死后逆转录聚合酶链反应（RT-PCR）确诊为COVID-19阳性的患者进行了完整的尸检。
男女比例相等。13例（65%）患者年龄在55岁及以上，同样比例（65%）的患者患有II型糖尿病和/或高血压。尸检时发现的最显著病理特征是弥漫性肺泡损伤。70%（14/20）的患者在肺、肾和心脏中伴有血栓栓塞。15例生前鼻咽拭子检测COVID-19结果为阴性的患者中，40%（6/15）在死后使用支气管肺标本检测结果为阳性。尸检时发现所有患者都有既往病史。
在所有研究病例中，弥漫性肺泡损伤是COVID-19死亡的关键病理特征，高血压和糖尿病是主要危险因素。没有合并症的个体死于SARS-CoV-2或患重症的可能性较小。
未声明。
